A Usenet persona calling itself BCITORGB wrote:

Scott:
===========
The argument made in the various letters from the Health Ministers of
Canada
worrying that a two-tier system would cause problems because the
clinics
would "cherry pick" the easy cases while leaving the hard, expensive
cases
to the state is idiocy.
============

Idiocy to you, but true. If one believes in a universal program of any
sort (I know you may not), then that program needs to be protected
against exactly that: cherry picking.

Why? What harm is caused by "cherry picking?" All it does is reduce the
costs of medical care for the poor, thus allowing them to get better care by
reducing the demand on the public system, while allowing individuals to
exercise personal liberty and seek out (and pay for) whatever medical care
they can afford.

"Cherry picking" is only bad when reducing the pool denies those excluded
access to the benefit.


Here in BC we have a "universal" auto insurance plan: if you want to
drive, you MUST have insurance.

What kind of insurance? Liability or personal injury?

Allow me to paint with a broad brush to
make my point -- there are minor and trivial exceptions to what I'm
about to say. And the insurance you buy MUST be provided by a
Provincial Crown Coporation. You may not buy your BASIC coverage from
anyone else. Why? Because, if the corporation is to gain the benefits
that come from having this monopoly and is to be able to provide the
blanket, global coverage the corporation was set up to provide, then it
cannot afford to have private insurers cherry-pick the low-risk
clients, leaving the crown corp to pick up the difficult, expensive
clients. [BTW, the premiums compare quite favorably to other
jurisdictions across Canada that use the private model]

Correct. This is true of insurance plans that are allowed to exclude people
and are allowed to control risks by excluding (by price or otherwise) those
who pose higher risks to the actuarial pool.

However, this problem does not apply when *everyone* is in the pool, by law,
and when the premium payments are extracted equally from everyone by
taxation, not by individual premium payments for those who are "in the plan"
or based on their perceived position in the actuarial risk tables.

In this case, people who choose voluntarily NOT to take advantage of the
coverage by buying and paying for their own insurance *which is additional
to the mandatory government coverage, for which they have to pay anyway* do
nothing but BENEFIT the members of the pool by NOT extracting money from the
pool when they can, and choose to pay the bills themselves.

"Cherry picking" is only a problem if the *individuals* in the pool are
allowed to opt out entirely and thereby not have to pay into the pool.

If, however, they remain in the pool, and have to pay into the pool
irrespective of whether they buy supplemental insurance or choose to pay for
the incurred debts in cash from their own assets, there is ABSOLUTELY NO
HARM to the pool as a whole, and in fact it benefits the pool by reducing
payouts.



Further, an anecdotal example of cherry-picking (that really ****es me
off): in the elementary school my daughters attended, there were two
sisters, one of whom was severely handicapped. The parents,
dissatisfied with the education their daughters were getting at this
school, took the daughter who was not handicapped, and sent her to a
very expensive private school. By doing so, they further diminished the
academic calibre of the school by taking a very bright girl out, and
leaving a handicapped one. This sort of cherry-picking diminishes our
ability to provide quality to everyone.

Hold on a second! You cannot compare the economic effects of insurance
cherry picking with some sort of "intellectual premium payment" that you
suggest a parent or child owes a school. What you suggest is that
exceptional children must be "leveled out," or required to suffer an
educational environment that does not best exploit their learning abilities
merely in order to provide some kind of egalitarian "level playing field"
for other children.

What you suggest is akin to educational slavery. You suggest that a bright
child, who can benefit from a higher quality, more expensive education that
her parents can both afford and wish to give to her, ought to be forced into
an inferior (for her) school in order to benefit *other* children. That's
just wrong. No parent, and no child, should be required to sacrifice
educational opportunities at the altar of socialist egalitarianism. Children
ought not to be made into sociopolitical pawns to salve what I intuit as
your bruised academic ego.

As for the "handicapped" one, she has a RIGHT to that education, by your
own argument, and to suggest that her presence drags down the educational
environment for other children, which ought to be balanced out by forcing
her sister into academic slavery, is astonishingly uncaring and dismissive
of the fundamental value of each child, no matter how handicapped. I can't
believe you really mean this.

I understand that you may not ascribe to that philosophy, but I do. If
one ascribes to that philosophy, then cherry-picking can not be
permitted.

What I see as implicit in your argument is that you believe that no one
should be allowed to excel or enjoy individual success above any other. This
is the essence of socialistic oppression, and it's why socialism always
fails.
--
Regards,
Scott Weiser

"I love the Internet, I no longer have to depend on
friends, family and co-workers, I can annoy people WORLDWIDE!" TM

© 2005 Scott Weiser